Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

Thursday, September 11, 2008

Tossing the Legionella Samples: A Case from the Homer Simpson School of Health Care Management

Sometimes you just cannot make this stuff up. Here are extracts of a story in the Pittsburgh Tribune-Review:

U.S. House members on Tuesday admonished Veterans Affairs officials from Pittsburgh for ordering the destruction of thousands of Legionella samples even as a researcher was attempting to save the 'irreplaceable' collection.

The destroyed samples represented nearly 30 years of medical research by Dr. Victor Yu, former chief of the VA's Infectious Disease Section, and Dr. Janet Stout, former director of the Special Pathogens Laboratory in Oakland and one of the nation's leading researchers in Legionnaires' disease.

During a congressional hearing held in Washington and carried live on the Internet, VA officials said they destroyed the samples because Yu and Stout did not provide a catalog of their research material after they were abruptly fired in July 2006.The officials said they tossed the vials six months later, unaware of their research and diagnostic value.

Rep. Brad Miller, D-N.C., chairman of the House Science and Technology subcommittee on investigations and oversight, was not convinced.

E-mail records show Dr. Mona Melhem, the associate chief of staff for clinical services at the VA's Pittsburgh Health Service, ordered the destruction of the samples shortly after learning that Stout would arrive at the lab the next day to pick them up.

'The most troubling part of this story is that the destruction of this one-of-a-kind collection occurred less than an hour after Dr. Melhem learned that formal steps were being taken, on the following day, to transfer the collection,' Miller said.

'All of us may pay a price for this conduct, veterans most of all,' he added.

Rep. Dana Rohrabacher, R-Calif., accused the VA panel of tossing the samples out of jealousy and spite.

'Have any of you had that kind of accomplishment?' he said, raising his voice. 'Have you reached that plateau yet in your career? Or is it that you're just looking through the refrigerators of people who are involved in that kind of activity? ... We've got a bureaucratic attitude problem here.'

Melhem testified she had no personal problem with Yu or Stout.

She said she shuttered the Oakland laboratory where Stout and Yu worked because it 'was not productive and was a drain on clinical resources.'

Melhem insisted repeatedly that she did not know the thousands of vials -- each marked with letters and numbers and placed in racks -- were being used for research when she ordered staff to toss them. Melhem said she and staff found "a freezer filled with unidentifiable specimens," some of them stored in 'broken or unidentifiable tubes.'

Michael Moreland, who headed the VA Pittsburgh Healthcare System at the time, said he was unaware of the collection's significance.

Here are some health care managers who seem to have come from the Homer Simpson School of Health Care Management.

Whether or not closing the laboratory was justified, throwing out what appears to have been a scientifically collection of samples because it was too much trouble to figure out what they were reaches a new low in management dumbness.

This is what Enthoven's call to break the medical guild and turn over health care to professional managers has wrought. D'oh.

Mona Melhem was completely out of control, at the same time she was ousting Yu and Stout, she was quite busy demolishing the Radiology Department at VAPHS.Ask around, and you'll learn this is the ways she does business, threats and retaliation is her M.O.For the record, Melhem hated Victor Yu from day one, and threatened him numerous times through their common acquaintances when she became the head of Clinical Support.

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